The general trend towards medicine at a distance will be driven by three factors. Firstly, an increased efficiency in European healthcare systems which will result from faster processing of information by specialists. Secondly, an increased quality in standards of healthcare, resulting from both more accurate and faster processing of the data.

Thirdly, and perhaps most important of all, there is the issue of cost. Significant cost savings can be achieved by the use of remote patient monitoring. These savings arise as a matter of the increased efficiency inherent in a system that is independent of the need for patients to physically visit the healthcare provider.

However, as is the case with many other new technologies the public sector capital is not forthcoming since the savings may take a number of years to realise. At the moment in the European market therefore the majority of activity takes place in the private sector. It is the outlook of the hardware companies that with an ageing population the market for remote patient monitoring will only increase. The challenge for these companies is to extract both revenue and commitment from the public sector healthcare providers.

The installation of a remote patient monitoring system is more than just about hardware issues. The main change that is needed is the ability to deal with incoming data without the ability to interrogate the patient. In a conventional situation the physicians have the ability to question the patient face-to-face. With most telemedicine applications this two-way dialogue does not exist. Much of the change is therefore targeted at day-to-day operations, staff and management thinking rather than specific ICT issues.

In terms of hardware many devices already incorporate some form of connectivity, however specialist medical equipment vendors are hoping the market will begin to emerge for devices suitable for the patient to purchase by themselves. However, the provision of telemedicine services by the public sector hardware costs is a critical issue. In a situation where patients visit the hospital one piece of equipment can be used to test many patients in a single day. When telemedicine is used the patients need their own equipment. The need to acquire these volumes of equipment is a discentive in the public sector. At the same time it is a key driver in the interests of hardware manufacturers. Health-care providers need to undertake a cost benefit analysis in order to ascertain whether the savings of telemedicine outweigh the costs of new equipment. For many providers simply the cost of acquisition of new capital equipment is sufficient discentive to further evaluate the technology.

An important aspect of the remote patient monitoring market is the role of the law in health care provision. Whilst patient safety is currently the responsibility of hospitals, the situation changes when a third party service provider is involved. A provider of equipment that delivers a diagnosis incorrectly must accept responsibility for the resultant patient outcome. This leaves such service providers liable to huge financial costs. Insurance against patient death will be costly. Such liabilities may restrain the provision of pay-for services. It is reasonable to assume the public sector health-care providers have both the expertise and the financial backing to withstand such a risk.

The question of management style and culture often appears when comparing the public sector and private sector provision of healthcare. Whilst it is true to say that virtually all healthcare professionals are dedicated to the improvement of services for patients, the emphasis on cost control is different between the two sectors. By examining the total cost of treatment it can be seen that telemedicine represents both value for money and the potential to make huge savings. However the costs associated with telemedicine are front loaded, which means that investment must be made before savings are realised and in the case for the cash-strapped public sector less investment will be encouraged. The total cost of a patients's disease treatment tends to be much higher in instances where prompt diagnosis is not made. Telemedicine can therefore significantly reduce long-term treatrment costs.